NEUROLOGY 2007;68:343-349
© 2007 American Academy of Neurology
Migraine prevalence, disease burden, and the need for preventive therapy
R. B. Lipton, MD,
M. E. Bigal, MD, PhD,
M. Diamond, MD,
F. Freitag, DO,
M. L. Reed, PhD,
W. F. Stewart, PhD on behalf of the AMPP Advisory Group*
From the Department of Neurology (R.B.L., M.E.B.) and Department of Epidemiology and Population Health (R.B.L.), Albert Einstein College of Medicine, Bronx, NY; The Montefiore Headache Center, Bronx, NY (R.B.L., M.E.B.); The New England Center for Headache, Stamford, CT (M.E.B.); Diamond Headache Center, Chicago, IL (M.D., F.F.); Vedanta Research, Chapel Hill, NC (M.L.R.); and Center for Health Research & Rural Advocacy, Geisinger Clinic, Danville, PA (W.F.S.).
Address correspondence and reprint requests to Dr. Richard B. Lipton, The Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY, 10461; e-mail: rlipton{at}aecom.yu.edu
Objectives: 1) To reassess the prevalence of migraine in the United States; 2) to assess patterns of migraine treatment in the population; and 3) to contrast current patterns of preventive treatment use with recommendations for use from an expert headache panel.
Methods: A validated self-administered headache questionnaire was mailed to 120,000 US households, representative of the US population. Migraineurs were identified according to the criteria of the second edition of the International Classification of Headache Disorders. Guidelines for preventive medication use were developed by a panel of headache experts. Criteria for consider or offer prevention were based on headache frequency and impairment.
Results: We assessed 162,576 individuals aged 12 years or older. The 1-year period prevalence for migraine was 11.7% (17.1% in women and 5.6% in men). Prevalence peaked in middle life and was lower in adolescents and those older than age 60 years. Of all migraineurs, 31.3% had an attack frequency of three or more per month, and 53.7% reported severe impairment or the need for bed rest. In total, 25.7% met criteria for "offer prevention," and in an additional 13.1%, prevention should be considered. Just 13.0% reported current use of daily preventive migraine medication.
Conclusions: Compared with previous studies, the epidemiologic profile of migraine has remained stable in the United States during the past 15 years. More than one in four migraineurs are candidates for preventive therapy, and a substantial proportion of those who might benefit from prevention do not receive it.
Commentary, see page 319
*The AMPP Advisory Group: Richard B. Lipton, MD (principal investigator); Marcelo E. Bigal, MD, PhD; Dawn Buse, MD; Michael L. Reed, PhD; Walter Stewart, PhD; Merle Diamond, MD; Frederick Freitag, DO; Elisabeth Hazard, PhD; Jonothan Tierce, CPhil; Elizabeth Loder, MD; Paul Winner, MD; Stephen Silberstein, MD; Suzanne Simons; and Seymour Diamond, MD.
Disclosure: This study was sponsored by the National Headache Foundation through a grant from Ortho-McNeil Neurologics, Inc. Drs. Lipton, Bigal, Reed, Freitag, and Diamond have received grants and honoraria in excess of $10,000 from Ortho-McNeil Neurologics Inc. Dr. Stewart has nothing to disclose.
Received July 7, 2006. Accepted in final form October 4, 2006.
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